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L. is a very athletic and well-behaved young girl with autism. Every time I was there, she was calm and seemed to really enjoy being there. According to her teacher N., she's a very good athlete, and goes to Sportizm Otizm Gençlik ve Spor Klubü (Sportism Autism Youth and Sports Club), which is a sports club specifically for people with autism. She came in first in a table tennis tournament for special needs athletes last year.

She's very quiet, and didn't show any stereotypical behaviors when I was there (I later found out that she generally doesn't show any). Her one problem is that she constantly needs someone to tell her what to do, even very trivial things. One time I was there, she was waiting for her teacher in the classroom with her coat and hat on. It was really warm, but she was just sitting there, sweating in her winter clothes. Her aide realized this later, and told her that she could take off her coat. She took off only the coat and not the hat, until the aide told her she could take the hat off, too.

Nn.

Nn. was one of the two girls with ASDs I've encountered during my week at TOHUM. She is mainstreamed into a few classes at regular school. She can speak well. Her biggest problem regarding autism is her problem behavior. She goes into tantrums quite frequently and it's hard to get her to concentrate after them.

One time when I was there, a couple of dentists were going around classrooms giving the children quick check-ups. It was Nn's turn. She was calm and well-behaved before, and even during the exam. They even let her look at the dental mirror as a reward for being such a good girl, however a second after she gave it back to the doctor, she started having a bad tantrum. She was screaming and hitting herself in the head with her fists. She also squeezed N., her teacher, very tightly around her arm (the next day she had a bruise there). N. was trying to hold her tight so she wouldn't hurt herself or anybody else, but when Nn. couldn't hit, she started to spit everywhere. She spit on the floor, on the table, and on her folder where she kept all her work. The teachers just let her sit alone for a few minutes, and when she finally calmed down, they made her clean up her own mess.

To be able to deal with her problem behavior (which poses even bigger problems at her regular school where her teacher doesn't know how to deal with it), they started a "contract" with Nn. In addition to her normal token economy board, they have a smaller one with only three tokens on it. N., the teacher, sets the timer to 2-minute intervals during each class, and if Nn. sits still, does her work, and doesn't yell or spit during those two minutes, she gets a token on that smaller board. If she behaves well for six minutes straight (i.e. gets all three of the tokens on the board), she gets to listen to music on her mp3 player for a minute. N. told me this has worked really well for Nn., and that she's been showing fewer problem behaviors ever since.

I also learned an interesting thing about how these kids answer questions via Nn. They were trying to teach her things about herself, and one of the questions was, "Are you a girl or a boy?". They kept asking this to her continuously, and to mix things up, they sometimes asked it in the reverse order, saying "Are you a boy or a girl?". I noticed that she always picked the latter in the question. She was a girl if they asked "Are you a boy or a girl?", and was a boy if they asked "Are you a girl or a boy?". I told the teacher about this observation, and he said that other kids tend to do this a lot, too.

K. is an adolescent who has a diagnosis of Asperger's. He's the only student who could come to TOHUM every day, and I was told that this helped him develop a lot. He's very verbal, and goes to regular school along with TOHUM. He rarely shows problem behaviors. The only time I saw him almost go into a tantrum was when there was a change in his routine. He was doing a typing task on the computer, and closed the program when he made too many mistakes. He wanted to open it again so he could finish the task, but his teacher wouldn't let him because he wasn't supposed to close it in the first place. She told him to just move on to the next task on his schedule, but he wouldn't do as he was told. He kept saying, "Please let me finish the typing task before I move on to the next one." She didn't let him do this so he could learn to be more flexible. He also has problems with eye contact, especially with women. He has a fascination with the female body, and has problems with looking at women’s faces, he just ends up staring at their breasts, or their legs if they’re standing up. When his teacher first saw that happening, she told me to cover my chest more with a shawl, but the more experienced teacher in the room told her to not do that, and to teach him to look at someone’s face when talking to them instead. It made lots of sense, because he’s going to be interacting with lots of women in real life, and needs to learn that it’s not appropriate to stare at their breasts. He was also especially interested in me, probably because I was a new person he’d never seen before. He kept distracting himself by looking at me, and laughing to himself. He gets distracted a lot, especially when the other child in the room was being loud, or doing something interesting. One time, he got really distracted and after a lot of frustrating attempts at bringing him back, the teacher got fed up and told him he was not being "a good older brother" (being a good older brother implies being a good example for younger children by showing exemplary behavior in Turkey). She said he was acting like a little child, and therefore would have to go to the little children's classroom and do his work there. So we went to the classroom she was talking about; it was a room with small chairs and small tables, K. couldn't even fit on the chair. She told him that if he does his work well, behaves like an older brother, and earns all the tokens on his board, then as a reward he could go back to his regular classroom. This seemed to work really well, he did a really good job in his task, and behaved himself back in the regular classroom. He's very easy to work with, and doesn't have issues with aggression, or hitting people. Therefore, the teachers let me work with him one-on-one on a few tasks. I got to do a conversation task, two money-related tasks, a math task, a comprehension task, and a typing task with him, with feedback from his regular teacher. It was a great opportunity to use my observations, and really gave me a chance to apply the things I'd learned from my reading, and what I'd learned at TOHUM. As K. got more used to interact with me, I started to also catch opportunities to teach him outside of his tasks. He has more problems with social interactions than he does with academic tasks, and I think it's very important to socially interact with children like him at every chance. One time, I was standing in front of something he wanted to grab for a task. He tried to move around me to get it, but I wanted him to interact with me, so I didn't let him. He said "can I get that?" without looking at me. I told him to look at me and say "can you please move so I can take that, Gizem Teacher (this is a common way students call their teachers in Turkish)", and when he did, I moved.

B. was in another classroom, but when I was talking to his teacher, he told me I should go observe him for a little bit "because he's the kid who is most severely affected by autism at TOHUM".

We could tell he was coming around 5 minutes before he actually walked into the classroom, because he could hear his screams. He puts one hand in front of his mouth, and one by his ear, and screams like this continuously. He has extremely clear speech as far as I can tell from the few moments when he stopped screaming. It's hard to get him to say what you want him to say. The only times I heard him speak were in between his shouting when he wanted or needed something (ex. "Give me water", "I won't"). They make him perform tasks even when he's yelling, which is an exception because they usually wait for the children to calm down before they're allowed to do anything. However, he doesn't stop screaming at all, so I guess they have to keep going somehow.

I wish I could observe him more, but I was told to leave the room when he started to get worse and showed a few attempts at hurting the people in the room.

A.I.

A.I. is a boy with a diagnosis of Asperger Syndrome. He has very developed vocabulary, and can speak very well, however he has a very flat tone of voice and speaks kind of formally. He also uses awkward social expressions from time to time. It was obvious to me that some of them were “learned”, as in, memorized and told to use in certain situations. For instance, whenever he went to his award board to pick something he wanted to do, he would say things like, “I’m going to play Wii games. They’re very fun,” with a very flat tone of voice.

His face is also "flat" most of the time, meaning he doesn't have varying facial expressions. That might also be why I thought his speech sounded a little forced, he would say things like "Playing computers is a lot of fun," but his facial expression would not change. One of the things they were trying to teach him at TOHUM was to smile when appropriate. They kept prompting him to smile when having small talk with his teachers.

He showed many examples of associative thinking. I think the following conversation is a good example of this:

Teacher: I guess you don't really like chess.

A.I.: I should play it without fear.

He used to make moves with fear of losing his pieces, so someone told him to play it more bravely. He makes associations like this all the time as far as I can tell from his speech. The following is another example. He was sick and needed to go to the infirmary.

Teacher: You should go to the nurse so she can take your temperature.

A.I.: I hate getting injections!

Another one of his problems is having to get his teacher's approval for everything he wants, or needs to do. For example, when his teacher tells him to get a ruler, he finds it, but instead of just getting it, he asks: “May I take the ruler?”. His teacher told me she decided to not reply to these questions so he would stop relying on people's approval so much. "He needs to learn to make independent decisions," she said.

M.H.

M.H. has been there since 2007, but hasn't shown much progress according to his teacher. He doesn't have any speech, and has lots of motor issues. He has trouble holding the boxes that his materials are kept in, or turning the pages of his folders. He also has sensory issues, especially with being touched. He really doesn't enjoy being touched. He gets very scared when someone does something sudden, and immediately takes a position in which he can protect himself. I asked if this could have anything to do with something that happens to him at home, like abuse by his parents. He said that they were also suspicious at first, so they looked into the situation (I wasn't given more details about how) and found out that it is not the case.

When I got to observe him, they were teaching him how to brush his teeth. They made a booklet for him and in each page, they placed a picture of him performing the several steps that are involved in brushing teeth. His task was to look at each page, perform what was on it, and then move on to the next page. This was the first part of the process. The second part involved model-learning skills. They took a video of his teacher brushing her teeth, putting emphasis on the separate steps, and he was asked to repeat them in front of the computer with his toothbrush. He could do it with some physical help, which, his teacher told me, was way better than three weeks ago when they first started.

O. is very similar to Eg. in lots of aspects. They're both non-verbal, and are being taught the same basic words, like "give", "open", "done", "come", "hi", "I'm good". He also has lots of problem behaviors. He has a problem with putting his hand in his mouth frequently and getting saliva all over himself, which was not tolerated by the teachers. They tried to deal with this situation by making him clean his own hand (with physical help) and squeezing it strongly so he wouldn't do it again. Additionally, he has a lot of difficulty maintaining eye contact. He always looks at something else, always from the corner of his eyes. To solve this problem, the teachers never give him prompts or reinforcements unless he's looking in their eyes.

I want to talk about how they teach these non-verbal kids some of these words, like "give" or "open". They use reinforcers such as food or tokens in all children, and give them to them when they do something correctly. But in O.'s case, they collected them in a plastic glass, and gave them to him all at once, only after he asked for them. This is how they taught him to say "give", they made sure he won lots of his favorite food, and then made him ask for it. His mother said she does that at home, too, which helped him generalize the meaning of the word. Now, whenever he wants something, he says "ver", which means "give".

They used a similar method to teach him to say "open". Whenever he needed to leave the room, his teacher stood in front of the door and wouldn't let him pass unless he said "open". He's still in the process of learning this word, so he still has some trouble with it, but hopefully he'll learn it soon.

I should also mention that it's not easy at all for these kids to just say the words, no matter how simple they sound. The non-verbal ones are mostly not very good at learning by modeling, so it doesn't always mean something for them when you tell them to repeat what you're saying. So, the teachers usually have to put the child's mouth in the necessary shape for a word with their hands, and wait for the child to make the sound.

Eg.

Eg. is non-verbal, and shows lots of typical autism-related behaviors. Not being able to keep on task or to maintain eye-contact are some of them. He also goes into temper tantrums pretty frequently and has trouble sitting still. N, his teacher, usually has to hold him down multiple times every session, his shouting is so loud that teachers from other classrooms come over to help sometimes upon hearing it. He's self-injurious at times, too - I saw him hit his head strongly with his own fists multiple times.

At TOHUM, they're trying to teach him to say some basic words, such as "come", "give", "open", or "done". They're also teaching him to respond to basic social interactions such as saying "hello" when someone says hi to him, or saying "I'm good" when someone asks him how he is.

Another thing that they teach him is how to wait, which is a very important skill to have in day-to-day living. They make him stand on a red piece of paper, and say "wait" while also showing him a red card with the word "wait" written on it. They set the timer, and if he stands still and doesn't show problem behaviors, then he's given a reinforcer - either food or a token. They also teach him how to wait on a chair. He's been pretty good at it, however sometimes he starts hitting himself, jumping up and down or shouting, in which case the timer's stopped immediately and his tokens are taken away.

He's very unpredictable, and can start shouting a second after he successfully says a word he's been taught. Therefore, it's really important to choose quickly consumable reinforcers, such as fruit juice or yogurt. This way, he finishes it quickly, and it's not still in his mouth if he starts doing something that is undesirable.

E.H.

E.H. was the highest functioning child with autism I saw at TOHUM. He was the only one who didn't have to use a token economy board for reinforcement - only verbal reinforcers were enough.

He was mainstreamed into regular school a while ago. He goes to TOHUM three times a week to supplement his regular school coursework.

He's very good at eye contact, and has almost no trouble holding a conversation with people, especially when the conversation's about something he's really interested in. For instance, he knows the plate number of every single Turkish city (there are 81 of them), and when one of the workers held a conversation with him about these numbers, he had no trouble keeping up. He's also good at initiating conversation, unlike the other verbal kids I encountered at TOHUM. He once asked me when I started working as a teacher (they introduced me to the kids as their teacher) and how long I'd be there, which really impressed me.

He knows how to play chess, apparently he started learning it just a month ago. He can set the board up, and knows how each of the pieces can move. He's not very good at thinking ahead and playing accordingly yet, but his teacher told me he's getting better at it.

However, he did have some obvious signs of autism. At times, he would get suddenly distracted and not respond to anything for a while, until he was touched and called by his name. He also fixated on certain things. For instance, when asked about what we do during summer (they were learning about seasons that day), he kept saying “we go to the lake to swim”, although it’s not common at all to do that in Turkey. Then, we found out why he would say that continuously: he told us a story about a friend who went to the lake one time to swim and “lost his life” there.

First Day at TOHUM

Today was an amazing day. I learned SO much in such a short amount of time. I took lots of notes, and here’s a summary of them along with some of my thoughts and impressions.

I got there at 9 am and met up with the person who’s responsible for interns. He was very helpful, and gave me lots of information about the school. In the main building, they teach around 25 kids throughout the entire day. These children are picked with a lottery, since there are hundreds who apply and no requirement except for having a diagnosis of autism to get in. The classrooms are separated by age, and in each room there are one or two kids and their teachers. Every child has an individual teacher, and there are also very experienced head teachers who inspect and help the regular teachers. Since they can’t give a full-day education to many other applicants, they have another division where they give 90-minute courses to children of varying ages and levels of functioning. These courses are also given one-on-one by very experienced and competent teachers. Every educator is thoroughly educated in ABA, and the school strictly follows the guidelines of the Princeton Child Development Institute (PCDI).

I was assigned to work at the second division (with children age ten and above). They put me there on purpose because lots of students come and go for short amounts of time, so I can see lots of variation in the abilities of the children. I got to fully observe five children today, three of them with speech and two without. The teachers put the same amount of effort into every one of them.

Each one of these kids was lovely, and they taught me a lot, even after just one day. But I also learned from the parents who came to drop them off and to pick them up. I was there when they were chatting with the teachers about their days. One was upset because her son had a temper tantrum in the bus because no one gave them a seat in a bus full of people and he had to travel like that for about an hour. Another was talking about how her other child was sick and they spent the weekend at the hospital… Her child with autism had a hard time sleeping there, so she couldn’t sleep either.

And these people are the lucky ones that got picked in the lottery. They get to leave their child with experienced educators for 90 minutes two or three times a week, during which they can have a cup of tea in peace and relax. What about the others who devote their whole lives into trying to deal with a child who can’t get any education and has to be kept home all day? It makes me sad that there aren’t more opportunities for autistic children in this country. Serving 130 kids, out of the possible 300,000 all around the country, is definitely not enough.

What I'm learning about ABA at TOHUM

Important things to know when teaching a child:

IEP = BEP = Bireysel eğitim programı

When you say things like "good job" or "great!" for reinforcement, also mention what they're doing well. Examples: "Good job putting your hands on your knees!" or "You're doing great, looking into my eyes!" or "I love how you gave me the spoon!"

Take back the "symbols" they earned if they do something bad. Do not give them reinforcers if you physically helped them do something. Only reward them for things they did independently. You can give them verbal reinforcement.

Giving easy puzzles may help calm the child down if he's having a tantrum.

Use things that can be consumed quickly - like small licks from a lollipop or sips from their favorite kind of juice. If you give them something that requires lots of chewing (like chocolate or gummy bears), they might behave in an undesirable way, but they would still have the reinforcer in their mouth, which would give them the wrong message.

When the child fails at a task for a long time, ask him something he already knows, then reward him.

Don't talk when they're doing the matching task so they can learn how to do it independently.

Do not let them make a mistake - lead them physically to the right choice.

Do not keep saying his name continuously to get his attention. Use methods such as touching, saying "look at me", or pointing their finger towards your face. NEVER grab them by the chin and turn them towards you with force.

When teaching a non-verbal child, alter the shape of their mouth with your hand to make them say it right.

Before every task, get the child to look at you.

Task sets like "turn around, touch your nose, touch your knees, stand up, sit down" help them concentrate. With higher-functioning children, you can also make them count, or tell you the names of his parents, etc.

Do not ask questions while doing the "conversation" task. Just keep responding to the child.

To see if the child can generalize what he's learned, make other people give them the prompts, or try to give the prompts in different environments.

Make sure your facial expressions match what you're saying. If you're telling the child you're happy with what they've done, smile and let it be known. If you're angry at the child, make sure you have a strong, disapproving expression.

The child doesn't necessarily have to do something to get an award. Not doing things like not shouting, not moving in place, not performing stereotypical behaviors are also good times to reinforce the child. Don't forget to make sure the child knows why he's being reinforced ("I really like how you're sitting quietly. Give yourself a token for sitting quietly.")

If you're asking the same question over and over again, the child might memorize the answer. To make sure this doesn't happen, ask other things to distract the child from the previous question, and then ask them the same question again to see if they're actually learned what the answer is.

Give physical cues instead of verbal ones.

Make the child clean up himself after the lesson is over. If he lacks the ability to do so, physically help him, but still involve him in the process.

Autism in Turkey

I'm almost 21 years old, and I spent around 19 of those years living in Istanbul, one of the largest cities in the world. How many children with developmental disabilities have I encountered in those years? 2. And here's how my encounters went.

The first child with autism that I encountered was a peer. We went to the same school in kindergarten. It was a private school for children whose families were upper-middle class and educated. B. was mainstreamed into our classroom - except no one in the classroom knew about his disorder other than the teacher and the teacher's aide when the year started. We all gradually learned about him through the secret conversations our mothers had with each other.

I heard that he "wasn't normal", one friend heard that "he wasn't supposed to be in our classroom but his parents just put him there to pretend he was normal", and another friend told us she heard he was "retarded". It was much later in my life (I think when I was in middle school) when my mother mentioned to me that he was in fact autistic.

Now that I think about it, he wasn't mainstreamed into our classroom at all. He was just put there. Perhaps the right approach would be to tell us, his classmates who spent 8 hours per day with him, about his condition and to teach us how to behave around him, to make life easier for all of us.

Children are cruel, especially without knowledge, and I remember they gave him a really hard time in that classroom. People complained about how he was a loner, and no one liked to be close to him because he would vomit in his mouth and after playing with it for a while, he would swallow it back. One time, I decided to approach him when he was sitting alone in a corner, rocking back and forth; I remember I thought he was crying. He wasn't, but I thought: "he must need a friend", so I went up to him and touched him on the shoulder to get him to look at me. He suddenly jerked away and pushed me, and I hit my head on the mirror and hurt myself. If only someone had told me why he had done that. Instead, they took him to another room and left him there all day, and he didn't come to school for almost a week after that. I was too scared to approach him again, and the teachers were even more scared to talk to us about this "awful boy".

My second encounter with a person with developmental disabilities wasn't any better. G. was an adolescent with Down's Syndrome. We lived in the same apartment building and the only people who knew about him were us (his neighbors) and his family. He was constantly kept at home, and the only place he was allowed to go to was the parking lot of our building. He wasn't even allowed to stand next to the door of the building because he "scared people". I was very young when we lived there, and every time he ran up to me to give me a hug, I'd be scared. Again, I didn't really know anything about Down's Syndrome, and so his extreme closeness to me - basically a stranger - was scary. Now that I think back, he never really did anything scary to me - he never hurt me, never intentionally tried to scare me; all he wanted to do was to give me a hug.

In my opinion, one of the biggest problems in our society is that people are embarrassed by things that they have no control over. If a woman is raped, she is "dirty" and is embarrassed by this "stain that will stay with her forever". If a man likes other men, he's "sick" and therefore should hide this illness - should be embarrassed by it. And if a mother has a disabled child, she is afraid of what others will say about her own abilities as a parent and will hide her son from the society. No matter what the subject is, they think hiding their problems from others will make them more tolerable for them, and for society. What they don't realize is that tolerance is what they should aim for, not tolerability. And tolerance doesn't usually just happen if you don't put yourself out there and fight for it.

Sicile-Kira shared some of her anecdotes in her book where she talked about being in public with her son. She said that even though a few years ago it was hard for her to be comfortable out there with her son, now it was much easier because people were more aware of what it meant to be autistic. She talked about one instance where she was trying to book a flight, and when she said she was traveling with someone with autism, the agent gave her a sympathetic look and told her that she knew exactly what she needed, because a friend of hers had an autistic daughter. If that friend had hidden her child from everyone else, this would not have happened.

Yes, people need to be more tolerant. But for that to happen, people need to be made aware. That's why I'm extremely excited about the special screening of "Temple Grandin", a movie about Grandin's inspirational life, followed by a long discussion on autism by professionals in the field and important public figures tonight. At least it's a start.

Thoughts on "Autism Spectrum Disorders: The Complete Guide"

I just finished reading the second book that my professor suggested to me. It was written by a woman who has a son with autism. She decided to write a book that she would've wanted to see on the shelves when she needed guidance herself, and succeeded.

It is a great book for parents. The language is very comprehensible, and she provides the reader with a lot of autism related resources. She recommends books written by professionals about autism and people with autism, mentions websites of non-profit organizations for autism, and even gives valuable guidance about law-related issues and special needs rights in the US. All in all, the book functions like a hand-book for parents with autistic children - it mentions almost everything about autism, talks about almost every treatment option available, etc, but only touches these on the surface and guides the reader toward more lengthy and in depth explanations by providing names of other books and related contact information.

However, it didn't teach me much that I didn't already know about autism. I don't think this was the fault of the book, I was just not part of the intended audience for it. The most rewarding thing about this book for me was that it gave me an insider's look of the disorder, one that was much more different and interesting than the one I got from Grandin's book. It was mostly information about lower functioning individuals, those who couldn't become professors at a college or write books. She did mention more able individuals, especially in the education and adult-life sections, but the focus was on the less exceptional ones. It also made me look at the issues about autism from a parent's perspective, and got me thinking about how I would deal with having a child who was autistic.

In her book, Sicile-Kira never once pretended her life was great, or even better with autism, like lots of other authors tend to do. Instead, she acknowledged the fact that it was difficult, but that it taught her lots of valuable things. She accepted the fact and decided to move on, and make her and her child's life as good as it could be. I want to include a few sentences from her concluding chapter here:

"As for me, I tend to believe that even without autism in my life, I would have met some wonderful people and become committed to some worthy cause. ... I could still have a wonderful, rewarding life without autism. What is certain, however, is that I have learned how fortunate I am that my body and mind work in sync, and how much inner strength I possess. I have also learned literally to stop and smell the roses and to take pleasure in the simple moments of daily living between the bombs falling."

- Chantal Sicile-Kira, Autism Spectrum Disorders: The Complete Guide

#chantal sicile-kira #otizm #autism #autism spectrum disorders #the complete guide #gizem iskenderoglu #book review

Teaching tips from Temple Grandin

The following is a bunch of information I thought would be extremely useful in teaching a child with autism, from a list that Sicile-Kira made in her book, Autism Spectrum Disorders (p.228-229).

Use the child's interests to teach him. "If a child likes trains and is studying math, ask him to calculate how long it takes to go from New York to Boston by train."

If an individual has problems processing auditory and visual stimuli at the same time, use only one when teaching to avoid confusion.

Teach in rooms that are quiet and lack distractions. Make sure the lighting isn't too bright.

Use the child's echolalia if he's echolalic. Temple Grandin suggests saying the word on a flashcard out loud in one tone and teaching the child what it is by having him repeat it. For verbs, perform the action while showing him the flashcard ("jump when saying jump"). Even having the word look like the action could help (write falling as if the letters were falling).

Some people can't hear consonants due to sensory processing issues. Overemphasize consonants.

Try singing words or phrases to them.

If the child likes to rock, teach him while letting him sit on a therapy ball.

Individual Benefits vs. Statistical Significance

In both books I've read this WT, I've encountered this sentence: every child with autism is different. Both authors stood strongly behind the idea that every individual with autism has different characteristics, and thus responds differently to different treatments. When I did some reading about treatment options, each one of them warned me that the specific treatment they were talking about worked for some individuals, and did nothing, or made things worse for others. Temple Grandin talks about the "wow factor"; she argues that unless the treatment has a visible effect on the child, then it should be stopped and another treatment should be started. With all of this in mind, I had this question pop into my head: what does statistical significance tell us in autism research, then? Given the fact that symptoms and responses to treatment differ on the individual level and cannot be generalized across all individuals with ASDs, then what do results from studies where they look at a generalized group give us? I've encountered many studies where they didn't find statistically significant gains from the treatment in their sample. However, according to what I have read so far, doesn't it make a difference even if one child in the study has seen benefits from the treatment? Therefore, would it maybe be more useful to conduct case studies, or maybe studies looking at specific aspects of autism, instead of the disorder in general? Not necessarily, although I do think case studies are much more useful in autism research than in most other areas. On the other hand, I think it's still very important to look at the results from bigger studies. First and foremost, it is important to know the risks as well as the benefits of some of these treatments, and parents/professionals making decisions about treatment programs should always keep these in mind, and consider the question: do the possible benefits outweigh the possible risks? Secondly, it is useful to know which treatments tend to produce more positive results, even if we can't just assume they're miracle cures for all autistics. It can give parents a good place to start: if the treatment works on their child, too, good for them, but if it doesn't, they can just move on to different options. Maybe the most important thing that researchers can do is to underline the rate at which the treatment works. They should not just rule out the treatment completely if there are even a few individuals who have benefited from it, and should report the rates of success and failure. This can guide parents and professionals in their journey to find the best option for the specific child.

A list of Behavioral Characteristics from Sicile-Kira, and what I have encountered so far

This list of typical behavioral characteristics in ASD individuals was taken from the following book, which is my second reading for Winter Term:

Sicile-Kira, C. (2004). Autism spectrum disorders: the complete guide tounderstanding autism, Asperger’s syndrome, pervasive developmental disorder, and other ASDs. New York: Perigee.

It is not a list of diagnostic criteria. It’s just a compilation of behavioral characteristics that are frequently observed in children with autism. The reason I decided to cite the complete list here was because as I was reading it in the book, most of the bullet-points sounded familiar. I realized that although I only went to Murray Ridge for about two months, I encountered most of these characteristics in the students there. I will write those in bold, and will include small anecdotes without using the children’s actual names, but only their first initials.

Impairment of Social Relationships

As a baby, does not reach out to be held by mother or seek cuddling

Does not imitate others

Uses adult as a means to get wanted object, without interacting with adult as a person

L. did this to me once. She just came up to me without acknowledging me as a person, dragged me to the shelf where they kept her favorite puzzle, and tried to make me give it to her. Instead of just handing it to her, I made her ask for it by gesturing (she’s non-verbal), and then gave it to her. I think using situations like this where they really want something to make them use communicative methods is a great way to motivate them.

Does not develop age-appropriate peer relationships

All of the kids in my classroom lacked this. Most of the time, they didn’t even show signs of being aware of their classmates’ existence in the room, except for when they were disturbed by a loud noise they were making.

Lack of spontaneous sharing of interests with others

Again, a general observation about all the children in my classroom. I specifically encountered this in Z. one day when I sat by him as he was drawing. I kept asking him what he was doing, what he was drawing, etc, but he wouldn’t want to respond. In the end, he said “painting”, but sounded like he was fed up with me bothering him, more than wanting to share his interest.

Difficulty in mixing with others

Prefers to be alone

I think the two bullet-points above are connected to each other. All the children in my classroom sat by themselves, and even when they were engaging in an activity, they did it alone.

Has an aloof manner

Little or no eye contact

Detached from feelings of others

None of the children seemed to care when a child from another classroom was having a temper tantrum right outside of our classroom door, except for J., who put his fingers in his ears as he does every time there’s a loud noise.

Impairment of Social Communication

Does not develop speech, or develop an alternative method of communication such as pointing and gesturing

Only Z. had any speech other than “yes” or “no”. L. could use a picture-board that made sounds to communicate basic needs.

Has speech, then loses it

Repeats words or phrases instead of using normal language

Z. did this a lot. According to Thinking in Pictures by Temple Grandin, this might be a way for a child with sensory confusion to try to make sense of what is being said to them. Maybe hearing things is more confusing to them than saying things. Z. showed echolalia almost every time I said something to him.

Speaks on very narrowly focused topics

This didn’t happen to me because none of the kids in my classroom had developed enough speech. However, I heard stories about how W. from the classroom across from us liked to talk a lot about comic books, and only comic books.

Difficulty in talking about abstract concepts

For reasons mentioned above, I couldn’t encounter this in my classroom, but I heard about how W. had a lot of difficulty understanding why he couldn’t be close friends with my classroom’s teaching aid. He didn’t understand the subtle difference between being someone’s student and being someone’s friend.

Lack or impairment of conversational skills

Impairment of Imaginative Thought

Inappropriate attachment to objects

J. had a wiggly toy that he held almost all the time. Z. had a heavy white blanket that he had to use to calm down when he got too excited. R. had a musical toy that he held close to his head as he paced around the classroom.

Obsessive odd play with toys or objects

Does not like change in routine or environment

The teacher in my classroom told me that his kids were pretty flexible with their routines, but that this was very rare among autistic individuals.

Will eat only certain foods

Will use only the same object

Repetitive motor movements

Other

Peculiar voice characteristics

Does not reach developmental milestones in neurotypical timeframe or sequence

Low muscle tone

Most of the kids with autism at Murray Ridge looked just like their neurotypical peers except for a few exceptions. I. had very low muscle tone, but I think it had to do with a comorbid condition that she had to autism.

Uneven fine and gross motor skills

I. had to practice motor skills almost every time I was there. She was given tasks such as attaching clothespins to the edges of a box, or putting dominos in a box through a very small opening.

Covers ears

J. had his ears covered almost all the time. His fingers went almost halfway in. He wasn’t allowed to use noise-blocking headphones at school upon his parents’ request, but could use them on the bus on his way home.

Does not respond to noise or name, acts deaf

Does not react to pain

One time, L. hit a metal locker upon falling on it, and even though I winced at the “bang” sound it made, she seemed like she hadn’t felt it at all.

Becomes stiff when held, does not like to be touched

Becomes hyperactive or totally nonresponsive in noisy or very bright environments

Eats or chews on unusual things

Puts objects to nose to smell them

Grandin talks about how sometimes individuals with autism consider people to be objects. Well… in that case this happened to me a lot. Z. really liked to come close to me to sniff me.

Removes clothes often

R. opened the buttons in front of his jeans and lowered them a little bit. J. pulled his shirt up quite a few times to reveal all of his upper body, but never removed it all the way.

Hits or bites self

C. hit herself and objects around her quite frequently. It was mostly her head, and the table.

Whirls himself like a top

Has temper tantrums for no apparent reason and is difficult to calm down

Hits or bites others

Lacks common sense

Does not appear to understand simple requests

This happened a lot with C. She would just stare at the teaching aid for minutes as she repeatedly told her to do something basic like, “put the cube on the table”. A lot of the time, the other kids didn’t do as they were told, but unlike C., they seemed to understand the requests. With them, it seemed more like the kids simply didn’t want to obey them.

Frequent diarrhea, upset stomach, or constipation

#autism #behavioral characteristics #gizem iskenderoglu #murray ridge #oberlin college #otizm #psychology #winter term #sicile-kira

My Thoughts on "Thinking in Pictures"

I just finished the first book I chose to read for my Winter Term project.

I picked this book mainly because it was the primary recommended reading by TOHUM, The Foundation for Early Diagnosis and Education of Autism in Turkey. This is the place where I'm going to do my observations next week, so I wanted to have an overall understanding of what they consider to be one of the best readings about autism.

First and foremost, this book is written by an individual with ASD, and as the cover in Turkish says, it's the "insider's view of autism". Temple Grandin does a very good job of talking about autism, and giving a general overview of the disorder. These parts of the book were very helpful and introduced some things to me that I want to do further research on, like squeeze machines, sensory rooms, Berard Auditory Integration Training, Sensory Integration Therapy, etc. However, she rarely went into depth about low-functioning autism. In general, the parts where she talked about autism were educational, but mostly about high-functioning individuals. Which is to be expected, since Temple Grandin herself is one of the most high-functioning individuals with autism that I've heard of.

That is the one thing that kind of bothered me about this book. Grandin is a very exceptional individual. She has a Ph.D., and is a very well-known advocate for animal rights and autism. She teaches at a university and designs top-notch systems for livestock facilites. Yes, she has a lot of autistic features and problems, such as severe social and sensory deficits, but she has the ability to understand them and deal with them in intellectual ways. Shortly, she is not the typical autistic that I have encountered at Murray Ridge or will be encountering at TOHUM. Therefore, although I was interested and impressed by her story, I don't think it gave me a real insider's view of autism. I have a feeling that although this might be a perfect insider's view of high-functioning autism, it barely comes close to explaining what the world of a lower functioning autistic is like.

I think it was a great introduction to the issues that autistic individuals face, and gave me lots of ideas on what I can read about the future. However, I also think her life and experiences are extremely exceptional, and I think it's very important to keep in mind that an overbearing majority of autistic individuals do not even come close to her level of functioning.

#temple grandin #thinking in pictures #resimlerle dusunmek #gizem iskenderoglu #otizm #tohum #otizm vakfi #autism #asd #oberlin college #winter term

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